A hospital on life support

Keith MagillExecutive Editor

Published: Saturday, December 1, 2012 at 10:45 p.m.

Last Modified: Saturday, December 1, 2012 at 10:45 p.m.

Terrebonne and Lafourche’s parish presidents have come forward with a plan aimed at keeping Houma’s state charity hospital running for a few months amid state budget cuts that threaten to dismantle its services.

With the extra time, officials hope, somebody can come up with a solution that might keep Chabert Medical Center open indefinitely.

Even those closest to the negotiations aren’t sure where this will lead. Some say the end result might be to find a private buyer, someone like Ochsner, a familiar and well-regarded New Orleans-based health system that provides resident doctors — medical students in training — to Chabert Medical Center.

I’m not sure whether Ochsner is at the table — yet, at least — but it wouldn’t surprise me if it were. The company has engaged in public-private partnerships for years, including one in which it operates Ochsner St. Anne Hospital in Mathews. And Ochsner has a vested interest in keeping Chabert open because it’s tough to find places to train residents, the doctors who will eventually work at the private company’s hospitals.

Maintaining the doctor-training program is a big reason local politicians are trying to keep the hospital open, at least in the short term.

Enter Terrebonne Parish President Michel Claudet and Lafourche President Charlotte Randolph. They revealed a plan last week that would send $2 million of Terrebonne taxpayers’ money and $1 million from Lafourche to Chabert to avert layoffs set to take place next month.

Gov. Bobby Jindal’s budget cuts, precipitated by a federal cut to Medicaid and the state’s own financial problems, will strip $14.3 million from Chabert, forcing the hospital to lay off 245 employees, a quarter of its staff. Those cuts would shut down most of the hospital’s beds, clinics and services. And they would threaten accreditation for the hospital’s doctor-training program, which handles about 75 percent of the patient care at Chabert. In short, without the residents, the hospital as we know it would cease to exist.

The local cash infusion could yield up to $6 million more in federal matching money, buying time to see if there is a way to keep Chabert open for the long term. Maintaining accreditation — a quality designation that is difficult, time-consuming and expensive to regain once lost — is critical to making Chabert attractive to any prospective buyer or private partner. It would be equally important to any new public entity created to run the hospital, something legislators have floated in the past.

The next hurdle will come later this month, when Terrebonne and Lafourche’s parish councils will decide whether to approve the parish presidents’ aid package. Some residents and council members are already concerned that the parishes have more important things on which to spend the taxpayers’ money. Others have noted that Chabert and the rest of Louisiana’s charity hospitals are the state’s responsibility. Still others question why more parishes — Chabert serves a large region of south Louisiana — aren’t putting up money instead of making Terrebonne and Lafourche bear the load alone.

Another question council members might ask is why some or all of the public hospitals in Terrebonne and Lafourche — TGMC, Thibodaux Regional, Lady of the Sea and Ochsner St. Anne — aren’t putting up money. Council members might pose that question to those hospitals’ board members, whom they appoint.

With nowhere else to go, patients who lack insurance or who rely on Medicaid would flock to the public hospitals. They are forced to care for patients who show up in their emergency rooms with serious ailments. And Medicaid rarely pays the full cost of care for the poor, so the hospitals would make up the difference. I suspect they don’t want that added expense or hassle and might be willing to put up some cash to avoid it.

One logical way hospitals might handle the increased cost is to charge paying patients or their insurance companies more to cover the cost of those who can’t pay their medical bills in full. So those patients will either pay more out of their pockets for care or pay more for the private insurance that covers their medical bills.

Still wondering whether this affects you?

Courier and Daily Comet Executive Editor Keith Magill can be reached at 857-2201 or keith.magill@houmatoday.com.

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